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岭南现代临床外科 ›› 2013, Vol. 13 ›› Issue (06): 503-506.DOI: j.issn.1009-976X.2013.06.009

• 论著·临床研究 • 上一篇    下一篇

腹腔镜辅助手术治疗进展期结直肠癌的应用体会

叶义标 罗兴喜 陈捷 张金岱 吴潇 陈涛   

  1. 中山大学孙逸仙纪念医院
  • 通讯作者: 陈涛

Experience of Laparoscopic-assisted surgery for treating advanced colorectal cancer

Ye Yibiao, Luo Xingxi, Chen Jie, Zhang Jindai, Wu Xiao, Chen Tao   

  1. Sun Yat-sen Memorial Hospital, Sun Yat-sen University
  • Received:2013-09-16 Revised:2013-10-08 Online:2013-12-20 Published:2013-12-20
  • Contact: Chen Tao

摘要: 【摘要】 目的 探讨腹腔镜辅助手术治疗进展期结直肠癌的疗效。方法 对作者2008年1月至2013年7月收治的20例进展期结直肠癌患者的临床资料进行回顾性分析,所有患者均接受腹腔镜辅助手术治疗,并记录近期疗效相关指标。结果 20例患者中13例行腹腔镜联合开腹原发灶及肝脏转移灶同期切除,2例行腹腔镜联合开腹原发灶及腹腔转移淋巴结同期切除,5例行腹腔镜下原发灶姑息性切除。20例患者的平均手术时间为182±56 min,术中平均出血量为340±28 mL,术后首次排气的时间为3.15±1.58 d,平均住院时间为10.26±1.89 d。有4例术后出现并发症:肠梗阻2例、肺部感染1例、电解质紊乱1例,均经保守治疗后恢复。结论 腹腔镜辅助手术治疗进展期结直肠癌在技术上是安全有效的,姑息性手术对减轻患者的创伤、解除肠梗阻症状及延长生命也有一定帮助,腹腔镜辅助治疗能为部分晚期结直肠癌患者提供较好的选择方案。

关键词: 腹腔镜, 晚期结直肠癌, 肝转移, 腹腔转移

Abstract: 【Abstract】 Objective To study the clinical efficacies on laparoscopic-assisted surgery in patients with advanced colorectal cancer. Methods The clinical data of 20 cases with advanced colorectal cancer in our hospital selected from January 2008 to July 2013 were retrospectively analyzed. All patients underwent laparoscopic-assisted surgery and the treatment-related evaluation indexes were recorded. Results Among that cases, 13 cases underwent simultaneous laparoscopy combined with open resection of the primary lesion and liver metastases, 2 cases underwent simultaneous laparoscopy combined with open resection of the primary lesion and abdominal lymph node metastases, 5 cases underwent laparoscopic palliative resection of the primary lesion. The average surgical time was 182±56 min, average blood loss was 340±28 ml, the first postoperative passing flatus time was 3.15±1.58 d,the hospitalization time was 10.26±1.89 d. There were four cases with postoperative complications, 2 cases of intestinal obstruction, 1 case of pulmonary infection, 1 case of electrolyte imbalance and all four patients were recovered under conservative treatment. Conclusion Laparoscopic-assisted surgery in patients with advanced colorectal cancer in technology is safe and effective. Palliative surgery will also contribute to reducing patient trauma, relieve the symptoms of intestinal obstruction and prolong life. Laparoscopic-assisted therapy would provide better options for some patients with advanced colorectal cancer.

Key words: Laparoscope, Advanced colorectal cancer, Liver metastases, Abdominal metastases

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